Sunday, March 11, 2012

Sunday March 11, 2012

I had the 1 to 3 shift today. I am the usual vet on Sunday's..

When we, (or rather mostly me), decided to open for walk-ins on Sunday's I got looks of "Oh My God, She Is Crazy!," and "God, she better not expect me to work on Sunday's" back from my associate vets. They wanted no part of Sunday duties.

But I decided to open anyway primarily for two reasons:

1. I knew my clients would appreciate it. I remember before I was a vet and my vet saw walk-in's on Sunday's. There were many a Sunday that I thanked the heavens above that she was available for me and my pets who always seemed to prefer to get sick on Saturday evening or Sunday morning . I never once had to go to the emergency room and a lot of that was because my pet's problem could be addressed by my own vet in a few hours, and I was lucky!

2. My husband and I needed to be at the clinic for a few hours each week. That used to mean that we made a special trip into the clinic to get "business bologna" done together either late one week night or over the weekend. Few things were more painful for me each week then going back to the clinic for another 3-4 hours after I had just left my hectic day behind. So we collectively decided that I would go into to see whatever walked in, and he could piddle around doing whatever he needed to do on Sundays. (This week his task is to try to figure out why  the toilets begin to run on their own, and try to fix the leak in the tank of one of them. Exciting!)

Some Sunday's (or every Sunday during football season when the Baltimore Ravens are playing at 1 pm) are very quiet. We use this time to catch up on cleaning and re-stocking, and each others family life. While others, like for instance today, are very very busy. On the days like today, Joe doesn't get anything done. He has no chance to get caught up on JVC stuff because I call him down to the floor to help out. He has been known to answer phone calls, book appointments, hold dogs and cats for diagnostics, take x-rays, keep clients company, and do ALL of the heavy lifting, (like the 150 pound plus dogs that need x-rays, or can't walk). He has become quite the well trained technician!

Last night was the clock change. The advancement of the clock one hour had most of us feeling like our already sleep deprived day was starting especially early because we had some people waiting for us at the door at noon.

I arrived at the clinic at 12:05. There were already two cars, (one of which had the 2 passengers inside of it sleeping, I shudder to think how long they were parked there waiting for us), out in the parking lot waiting for us to open up.

Both cars were worried clients with sick cats, who were very grateful and releived that we are here on Sunday's. (Oh, how I vividly remember that feeling).

My first appointment was with Boomer a very large, long haired, grey and white domestic long hair. He is diabetic, and thankfully a very good patient.

This is Boomers wound. His tail is lifted straight up and goes to the 1 o'clock position. His left anal sac is abscessed. It is the red circular wound. His anus is just to the right of the wound at the 2 o'clock position. We shaved all of the surrounding hair away.
He was brought in for a wound that his owners found near his rectum. Because he is a long haired cat we trimmed that hair around the wound. I always warn owners that the hair trimming is a very necessary thing because all of the hair precludes us from being able to see and treat the wound. But it also makes that wound look about a thousand times worse than it did when they walked in the door. Trying to treat a wound with hair in it is almost impossible.

Turns out after we shaved all of the surrounding hair that Boomer had an anal gland abscess. We see this much more often in dogs than cats.

For various reasons the anal sac (the correct term is sac, because it is a "sac" and not a "gland") does not empty as it should normally with each defecation. Because some of this anal sac secretion material is retained the sacs begin to over fill over time. At some point the sac(s) become(s) impacted and they begin to wear through the skin surrounding them until they rupture. Most pets with overfull sacs and/or impacted sacs will lick, scoot, or bite at the perineum (anus area). Some pets will also chase their tail, (because they are trying to reach their anus) or have difficulty or are painful when defecating. The skin around the sac can only stretch so much, after it is stretched to it's limit, the sac ruptures. And the pet now has an open wound, (but finally some relief from the pressure of the sac being full).

If we see a pet with an impacted sac we first try to medically manage the wound. Many people want to treat the impacted sac like a boil and lance it. PLEASE don't do this. A wound by your anus has a very high likelihood of becoming infected, and nobodies butt is that clean. We often use warm compresses of an antibiotic solution, oral antibiotics, and pain medicines to treat these. In most cases we can stop the impacted sac from becoming infected and rupturing.

It was too late for this for Boomer however. His left side anal sac had already ruptured. Based on the degree of tissue damage around the rupture I would say it ruptured a few days ago. His infected anal sac might have been made worse by the fact that he is a diabetic. We know in both human and animal medicine that diabetics have a weaker immune system and are more susceptible to wounds and heal much slower.

Boomer was given some SQ fluids, an injectible antibiotic because his owners weren't confident that they could pill him, and an injectable pain medication. We sent him home with a shaved butt, an antibiotic solution so they could try to give him warm compresses twice a day, and an e-collar just in case he starts to lick his wound.

Boomer being a very good boy. This is even after we shaved his sore butt, cleaned it and compressed it. He is getting some SQ fluids now. Mom and dad lend a helping hand on the right, my technician gives him his fluids on the left.

Just like your butt, your mouth is full of bacteria too. So licking wounds just adds more bacteria to an already infected infection.

I will keep you posted. He needs to be watched closely. I am concerned his butt will have an especially difficult time healing because of his diabetes.

Today I also saw;
FIV positive cat that the owner found last week after having been missing for 8 months
a sweet happy black lab with a broken toenail
a very sick cat who was unable to walk because his feet were so infected, and he was blind with both of his eyes full of blood, (great case!, but I am still not sure what is wrong with him),
a yellow lab who parents were away for their first vacation in 5 years, They just got home to find their dog not eating.
a very thin hyperthyroid cat who is vomiting
A severely jaundiced, very sick young black lab,

See how many great stories and cases I have yet to talk about this week! All of those cases in 2 hours. THAT'S WHY I LOVE SUNDAYS! You never know what is going to come in and I helped a lot of very sick pets today.

Stay tuned!

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